Endocrine Diseases

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Diagnosis of Goiters

Goiters can affect anyone. They may be present at birth and occur at any time throughout life. Goiters are more common after age 50.

The risk factors for goiters include:

Lack of dietary iodine:
People living in areas where iodine is in short supply and who don't have access to iodine supplements are at high risk of goiters.
Sex:
Women are more prone to thyroid disorders than men, so they're also more likely to develop goiters.
Age:
The risk of developing goiters increases after the age of 50.
Medical history:
A personal or family history of the autoimmune disease increases the risk of developing goiters.
Pregnancy and menopause:
Thyroid problems are more likely to occur during pregnancy and menopause.
Medications:
Some medical treatments can increase the risk of goiters, such as immunosuppressants, antivirals, heart medications, and psychiatric drugs.
Exposure to radiation:
The risk of goiters increases if the patient had radiation treatments near the neck or chest area, or if the patient has been exposed to radiation in a nuclear facility, test or accident.

Complications:

Small goiters that don't cause physical or cosmetic problems aren't a cause for concern. But large goiters can make it hard to breathe or swallow and can cause a cough and hoarseness. Goiters that result from other conditions, such as hypothyroidism or hyperthyroidism, can be associated with a number of symptoms, ranging from fatigue and weight gain to unintended weight loss, irritability and trouble sleeping.

Diagnosis:

The doctor may discover an enlarged thyroid gland simply by feeling your neck and having you swallow during a routine physical exam. In some cases, your doctor may also be able to feel the presence of nodules.

Hormone test:
Blood tests can determine the number of hormones produced by the thyroid and pituitary glands. If the thyroid is underactive, the level of thyroid hormone will be low. At the same time, the level of thyroid-stimulating hormone (TSH) will be elevated because the pituitary gland tries to stimulate the thyroid gland to produce more thyroid hormones.
Antibody test:
Some causes of a goiter involve the production of abnormal antibodies. A blood test may confirm the presence of these antibodies.
Ultrasonography:
A wand-like device (transducer) is held over the neck. Sound waves bounce through the neck and back, forming images on a computer screen. The images reveal the size of the thyroid gland and whether the gland contains nodules that the doctor may not have been able to feel.
Thyroid scan:
During a thyroid scan, the patient will have a radioactive isotope injected into the vein on the inside of their elbow. The patient then lies on a table with their head stretched backward while a special camera produces an image of the thyroid on a computer screen. This scan provides information about the nature and size of the thyroid, but it is more invasive, time-consuming and expensive than an ultrasound test.